Covid Vaccination Argentina

6 October 2021 by Pablo Sigal
The Delta variant is already present in almost 1 out of 10 new community circulation cases tested. It was recorded in 8.83% of local Covid samples sequenced in the last two weeks. Incidence increased fivefold in that time frame. The Manaus variant remains predominant for now.
The proportion of cases of community circulation of the Delta variant increased fivefold in the last two weeks, according to the Ministry of Health's new October report, which analyzes the situation up to epidemiological week 36. It represented 8.83% of the total number of cases sequenced in the period, compared to 1.69% in the previous fortnight. Between week 36 and week 34, the Malbrán Institute sequenced 645 samples and 57 new cases of Delta variant were added. In the previous period (between weeks 34 and 32) 1,004 samples had been sequenced and 17 Delta cases were found. Cumulatively, from January to the present, Delta represents 1.91% of the total of 5,177 sequenced cases, while two weeks ago it represented 0.93% and one month ago, 0.68%. This progression shows the speed with which the curve of the variant that originally emerged in India is growing.

The Manaus variant (Gamma) remains predominant in the country, with 62.51%, a slight variation with respect to September when 61.52% was recorded. This sustained relevance is what experts consider to be one of the possible explanations for the Delta still remaining contained at relatively low values. In absolute figures, according to the low number of sequences performed (in the last 14 days, 46 were performed per day when the average number of cases per day was 1,190, or 3.86% of the total), 99 cases of Delta variant have been recorded in the country. This figure should be projected to the total number of registered cases to get a more realistic picture. Of these 46 sequences per day, 4 were Delta, but if one were to calculate the 8.86% proportion that the variant represented in the period analyzed, with respect to the total number of cases (16,670), 1,476 new cases of Delta would have been added in the last two weeks. The data is an inaccurate approximation for three reasons: the first is that Malbrán usually analyzes cases that are already under suspicion which could belong to a variant of concern, especially -now- to the Delta. The second is that asymptomatic cases are not even tested and are left out of the registers (although with the current low positivity this variable weighs less). The third is that genomic surveillance in the country is poor and uncertain. The 99 cases of local circulation of Delta confirmed by genomic sequencing are distributed as follows: 41 in the City of BA, 20 in Santa Fe, 17 in Buenos Aires province, 14 in Cordoba, 2 in Corrientes, 2 in Mendoza, 2 cases in Salta and 1 in Tucuman.

In regards to cases of travelers, 57.75% of the variants sequenced corresponded to the Delta variant, against 17.73% for the Gamma variant. Two weeks ago, the proportions had been 52.83% for the Delta variant versus 18.98% for the Manaus variant. This means that the import of Delta continues to rise compared to the other variants, which then has an impact on the increase of local circulation cases. In this context, the Gov't decided yesterday that as of October 19 (in two weeks) it will lift the ban on international flights.


For now, this increase in the incidence of the Delta variant is not yet relevant enough to produce a rise in the curve of cases due to its higher transmissibility (60% more than that of Manaus). According to the Worldometers website, in the last 7 days the number of cases registered a decrease of 22%. And the number of deaths, 38%. The indicator to be observed, however, is not only whether the curve continues to fall, but also to what extent, in order to determine the trend and whether this decline slows down at some point. Based on the data recorded, the number of community infections with the Delta variant shows a more evident increase when measured in terms of active cases. On the other hand, when the universe of cases is measured from the beginning of the year, the proportion of Delta obviously drops. But for epidemiological purposes, this is anecdotal. The key is to know how much Delta cases are increasing today, when the Gov't is encouraging people to stop wearing their masks in the street and the public is allowed to go to soccer stadiums without being able to control the capacity.

 
Delta is coming - the good thing is it should happen during summer time which will lessen its impacts. High vaccination rates will also help.
 
6 October 2021
Coronavirus: ANMAT also approved Janssen's vaccine. The entity indicated that "the new medicinal specialty presents an acceptable benefit-risk balance".
...."Authorize the firm Janssen Cilag Farmaceutica S.A. the conditional registration for the purpose of its use in the Registry of Medicinal Specialties (REM) and of the National Administration of Medicines, Food and Medical Technology of the medicinal specialty of commercial name COVID-19 Vaccine Janssen", ordered the entity under File No. 1-47-2002-000686-20-3. It was established that "since it is a conditional authorization, the certificate shall be valid for one year as from the date of this provision". The text also specified that the company must "submit periodic safety reports every 6 months after the effective commercialization of the product to the INAME (National Institute of Medicines)". It also clarified that "any change in the safety or efficacy profile of the product must be evidenced in the corresponding modification of the package insert", and added that, in the event of non-compliance with the obligations set forth, ANMAT may "suspend the marketing of the product approved by this provision, when public health considerations so warrant". Janssen's vaccine is the first to be included by WHO as a single-dose regimen that can be kept in a classic refrigerator, which should facilitate vaccination logistics in all countries.

On the other hand, a month ago, Johnson & Johnson announced that its vaccine reaches 94% effectiveness when two doses are administered and that those who receive the booster injection are better protected for a longer period of time. According to the information provided by the same company, the application of the single-dose vaccine generates up to 66% protection against severe and moderate cases of coronavirus. The same study - carried out by the company in the United States - also indicates that if the booster dose is applied six months after the first one, it could be even more effective and generate twelve times higher antibodies four weeks after the second injection, regardless of the age of the person receiving the vaccine.
 
6 October 2021 by Jose Maria Acosta
The Gov't will not buy the Janssen vaccine for now, despite ANMAT's endorsement. LA NACION was informed by official sources, the U.S. laboratory would not have stock to deliver doses in the coming months; it would only be negotiated for 2022. After the publication on the ANMAT website, LA NACION consulted official sources as to why the news was not disseminated and they answered: "It is something that the laboratory did directly with the regulatory authority. We did not interfere". "That vaccine will not be bought this year. The laboratory already closed their negotiations for 2021 and agreed to resume contact when they have news for 2022″.

The Janssen vaccine showed an efficacy of 66.1% to prevent symptomatic cases 28 days after the single dose. To prevent severe cases, its efficacy rises to 85.4% in the same period. Clinical trials were conducted in: Argentina, Belgium, Brazil, Canada, Chile, Colombia, France, Germany, Japan, Mexico, Netherlands, Peru, Philippines, South Africa, Spain, Ukraine, United Kingdom, United States.

The drug, which uses a non-replicating viral vector, is produced in Spain, the United States, France, India, Italy and South Africa. Frequent adverse effects include: pain at the injection site, headache, fatigue, myalgia, nausea, fever, injection site erythema and swelling at the injection site. Rare cases of blood clots with low platelets have also been reported. The doses, which are for intramuscular application, have a shelf life of two years if the storage temperature is -20°C. On the other hand, it drops to 3 months if stored at a temperature of 2°C - 8°C. The price ranges from US $8.50 to US $10....
 
6 October 2021
Flights with Covid-19 vaccines continue to arrive in the country, although they are no longer newsworthy.
This Wednesday, 848,250 doses of the Pfizer vaccine arrived in Argentina by an American Airlines flight, out of a total shipment of 1,625,130 doses. The rest were scheduled to arrive, also by an American flight, on Thursday. They are part of the contract signed by the government with the American laboratory for 20 million doses, to be delivered in the last quarter of the year. On the other hand, on Saturday, Aeromexico flight AM 030 from Mexico City arrived at Ezeiza with a consignment of 1,673,000 AstraZeneca vaccines....During the previous week, a batch of 1,440,000 doses from Sinopharm, 549,600 from AstraZeneca, donated by Canada, 160,290 from Pfizer and 822,100 also from AstraZeneca, which are part of the bilateral agreement for the production of the active ingredient in Mexico and its subsequent formulation and packaging in Mexico, had arrived in the country.
 
9 October 2021
The end of the second wave? Coronavirus in Argentina: 753 new infections and 28 deaths registered.
The National Ministry of Health report confirmed 753 new infections in the last 24 hours. These records bring the total number of cases to 5,265,058 since the beginning of the pandemic. In addition, 28 new deaths of patients with coronavirus were recorded, bringing the death toll in the country to 115,444. In the Buenos Aires Metropolitan Area, 247 positive cases were detected in the Province of BA and 106 in the City of BA. During the day, 33,285 diagnostic tests were performed and since the beginning of the outbreak, 24,190,048. There are currently 981 people hospitalized in Intensive Care Units: 35.9% of ICU beds are occupied nationwide and 41.6% in the Buenos Aires Metropolitan Area.
In detail....
 
8 October 2021....Interview by Jorge Fontevecchia, Cofounder of Editorial Perfil - CEO of Perfil Network.
Roberto Debbag: "We are in a transitional moment between a pandemic and an endemic". He is one of the most powerful voices in pediatric infectious diseases worldwide. From that place, he calls upon his colleagues and the authorities to get out of the "grieta" and decide health strategies based on scientific evidence. Dr. Debagg highlights the importance of empathy and what Sigmund Freud called transference as a therapeutic strategy. He affirms that humanity is living in a pandemic era and explains the causes and possible consequences of the situation....
 
Continued....
-What are the reasons for the delta variant not reaching Argentina?

-My guess is not based on epidemiological impact models, but on experience and learning about the pandemic. What is called the ping pong effect of the coronavirus is: first it appears in the United States, then in Costa Rica. It goes through different places. The variables are whether you had a lot of infection or vaccination with two doses. The system is stressed throughout Costa Rica, I talked to colleagues at their children's hospital. The same happens with some cities in Mexico or Brazil. Circulation of the delta variant is backward. Nobody can say that delta is not circulating in Argentina. We cannot say to what extent, because we are not studying it. Countries with low or moderate resources should study genomically 6% of all the people who have a positive PCR to know which variants are circulating. In Argentina it is 0.1%. Out of 3,600,000 cases this year, only a little more than 5,250 or 5,285 were studied. This is a very low test. We had a first supercontagious event in Argentina, which was the ORT school. More than sixty children had, only three were studied with delta. They did not continue studying because they are all delta. I attended some cases of that event and all the members of the family were infected, including some with two doses of vaccine. The delta variant is present, although in low magnitude. My impression, which I share with other specialists, is that in Argentina there are more than 5 million infected people, but 3,600,000 people were infected this year, in a group of weeks around July.

- Do the antibodies persist as if we had three vaccines?
-Exactly. We have 3,600,000 people, but there is a variable: a number to be multiplied by the one who knows how many people were infected. The variable can be from 3 to 10, let's say 4. 3,600,000 times 4, that's more than 12 million. Those 12 people received the best vaccine. It is unfortunate that it is the best vaccine, because it is the virus. A vaccine that produced thousands of deaths. It was not good and could have been avoided. It happened, but it gives a column of more than ten to twelve million people infected and no more than five months ago. In infected people, who had covid-19 or two doses of vaccines, immunity begins to decrease after 6/8 months. Today, the pandemic occurs in three groups: the unvaccinated, those who have only one dose of vaccine or those who have two doses of any of the vaccines, but have comorbidities. Among them, three fundamental ones: very advanced age, obesity and diabetes. That is the new pandemic. There was a 2020 pandemic and a 2021 pandemic. Now it's a new one. If we are so close to this pandemic outbreak, plus the two-dose vaccination, we have protection. The delta variant will circulate with a little more intensity, yes. But it will not be pandemic with these outbreaks. That's probably the effect going forward. The eighth, tenth month we will be looking at an increase in cases. The situation will be determined by the distancing methods, the protocols.

-What happened in Europe could happen in Argentina in February?
-I hope we are making a mistake. May the great protection provided by vaccines and all that is promised in these next months of RNA vaccines serve for the reinforcement of the elderly or health workers and those with comorbidity. Let that boost their immunity so that they will be the most protected in 2022. Post-pandemic freedoms cannot be of abrupt acquisition. There are papers in which schools of public health in Europe, Portugal, Spain, France and England say that new, smaller waves should be avoided. They suggested not to open health restrictions abruptly, but to get used to freedoms under protocol. There are people who can criticize the 50% capacity in a soccer match and that they were not fulfilled in recent times, specifically in the Boca and River match. From the two political bells, there are those who say that it is crazy to gather 57 thousand people with a single dose. Others say that freedom, soccer, meetings are important. From science I say that if I have an adequate process for 50 thousand people to enter that stadium and the adequate process is that they have two doses of vaccine and 15 days after the second dose, I know that the risk is low. July 29th was Lollapalooza in Chicago. There were 385 thousand people. It was documented after a month how many people had been infected. Just over 200. Nothing, or close to nothing. But of those who entered Lollapalooza, 90% had two doses 15 days later and 10% were PCR negative because it was essential and had not been vaccinated. To see Lady Gaga in New York, you pull out your ticket and cross over with your vaccination status or your vaccination card. That ticket has an identity. I have to arrive with a ticket and my document. Without complications, applications, without thinking if you are from the province or the Capital. I am not afraid of the number of 50 thousand people if everyone is vaccinated. I would love the Ministry of Health to say how many of those 50,000 people who came in had two doses and more than 15 days. That data is not available. And having it is also science: the management of Big Data for future decision making.


-From an ethical point of view, should vaccination be compulsory or subject to free will?
-I find it hard to believe that people do not want to be vaccinated, perhaps because of my experience. Now, the world is not divided into the antivaccine and the pro-vaccine of before the pandemic....
 
9 October 2021
Uruguay may offer to vaccinate Argentine tourists with Pfizer and Sinovac doses. The Uruguayan ambassador in the country, Carlos Enciso Christiansen, assured today that his country could offer vaccination against the coronavirus with Pfizer and Sinovac doses to Argentineans visiting the country. These are two of the six formulas approved by the WHO, which allow entry to the United States and Europe. "The tourist who does not have the complete cycle can go for several days, do the quarantine, and then it is feasible, it is yet to be defined, that he/she can also be vaccinated in Uruguay", said the diplomatic representative. And he added, in a dialogue with Radio Mitre, that it could also be offered to those who have two doses applied in Argentina. "It is a decision that is being evaluated and the announcement would be made in November. It is a quite feasible possibility, to be friendly with tourists in general, not only with the Argentineans", added Enciso Christiansen.

In this sense, he assured that it is being discussed that there will be "a minimum of residence time for tourists to avoid collapses; I estimate, because it is still being discussed, that there will be a minimum of permanence in the country to have the right to the vaccine". With regard to the flexibilizations, the Uruguayan ambassador in Argentina said that in November " normality will practically return from the migratory point of view, with the addition that for everyone, up-to-date vaccinations are required". "To this we must always add the negative PCR. With that there is no quarantine and they enter as in normal times, if I may say so, as from November 1 through the authorized entry routes, which are by river and air, and not the bridges because that is a decision mainly up to the Argentine authorities," he added. The diplomat also assured that in order to enter the country, minors must have at least one dose applied of the vaccine.

"What we are also looking at is to vaccinate minors from 12 to 18 years of age in Uruguay, as a measure to support those who go as tourists. It is something imminent that the authorities are about to define". Among other things, Enciso Christiansen also made a clarification to "bring peace of mind" to those who cross into Uruguayan soil from Argentina: "For us, the Sputnik V vaccine is accepted, as well as all those which, in general, are authorized by the sanitary organisms of each country", he said. And regarding those who must carry out the quarantine, he pointed out that "isolation in Uruguay has always been done at home". "Nothing indicates that this will change in the future, anyway they are evaluating the implementation", he concluded.

Yesterday, on the other hand, the United States announced that it will allow entry into its territory to persons who are vaccinated with any of the six formulas already approved by the World Health Organization (WHO), according to a spokeswoman for the Centers for Disease Control and Prevention (CDC). In this way, those who have the complete regimen with any of the following vaccines will be able to enter the United States: Moderna, Pfizer, Janssen, Oxford/AstraZeneca (and its Indian version, Covishield), Sinopharm and Sinovac.
 
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